COUNTY AS S ES S MENTS DEP ARTMENT OF HEALTH & HUMAN S ERVICES November 13, 2018 1
DHHS Mission The Department of Health and Human S ervices (DHHS ) promotes the health and well-being of Nevadans through the delivery of essential services to ensure families are strengthened, public health is protected, and individuals achieve their highest level of self-sufficiency. The department consists the following divisions: Aging and Disability S ervices, Child and Family S ervices, Health Care Financing and Policy, Public and Behavioral Health, Welfare and S upportive S ervices, and the Public Defender's Office. S tatutory Authority: NRS 232.290-465. Helping People. It ’s who we are and what we do. 2
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Current County Assessments ADS D – Developmental S ervices DCFS –Y outh Parole S ervices DCFS –Y outh Alternative Placement DCFS – Child Protective S ervices DPBH – Environmental Health S ection DPBH – Community Health S ervices DPBH –TB Medical Care DPBH – S TI Medical Care DPBH – Lakes Crossing DHCFP – County Match Program DHHS Director’s Office – Public Defender 4
ADS D – Developmental S ervices Description/ Purpose The t hree regional cent ers (Rural, Desert , and S ierra) provide services and support t o individuals wit h int ellect ual and development al disabilit ies. Rural Regional’s service area encompasses all of Nevada wit h t he except ion of Washoe Count y and t he Las Vegas area. Desert Regional’s service area encompasses t he Las Vegas area in Clark count y. S ierra Regional’s service area encompasses Washoe Count y. S ervices provided include Target ed Case Management (S ervice Coordinat ion) as well as respit e, resident ial, clinical, nursing, j ob support s, and coordinat ion wit h communit y resources. Authority/ Methodology NRS 435.010 allows Aging and Development al S ervices t o receive reimbursement for t he cost s of services t o children from t he count y of residence of t heir cust odial parent . For all Rural count ies, quart erly assessment s are invoiced t o each count y based on t he previous year’s act ual cost s of services wit h an end of year set t le-up t o mat ch current year’s cost s. For Clark and Washoe count ies, cost s are based on t he act ual cost of t he services provided. 5
DCFS –Y outh Parole S ervices Description/ Purpose The Division of Child and Family S ervices provides supervision and case management services to youth committed to the Y outh Parole Bureau following adj udication of a delinquent act. Authority/ Methodology NRS 62B.165 allows the Division of Child and Family S ervices to assess each county to support half of the costs incurred for the Y outh Parole Bureau. The assessment is calculated by subtracting revenue received from Child S upport and Medicaid from the total expenditures budgeted for the operation of the Y outh Parole Bureau. The remaining expenses are split 50 percent to county assessments and 50 percent to General Fund appropriations. Each county is assessed based on their proportionate number of pupils enrolled in grades 7 through 12 in public schools in the preceding school year, as reported by the Department of Education. 6
DCFS –Y outh Alternative Placement Description/ Purpose The Division of Child and Family S ervices provides financial support t o each regional facilit y for t he t reat ment and rehabilit at ion of children part ially support ed by t he st at e and is operated by a count y whose populat ion is less t han 700,000. Two regional facilit ies in Douglas Count y-China S pring Y out h Camp and Aurora Pines Y out h Camp-are current ly t he only t wo regional facilit ies t hat qualify and are part ially support ed wit h pass- t hrough count y assessment funding received by t he division. Authority/ Methodology NRS 62B.150 allows t he Division of Child and Family S ervices t o assess all count ies wit h a populat ion less t han 700,000 t o support t he regional facilit ies for t he t reat ment and rehabilit at ion of children part ially support ed by t he st at e. The assessment amount is based on t he Legislat ively approved amount , and any changes wit h t he split bet ween st at e General Fund appropriat ions is t ypically negot iat ed bet ween t he part icipat ing count ies and all int erest ed part ies prior t o approval. Each count y is assessed based on t heir proport ionat e number of pupils enrolled in all schools in t he preceding school year, excluding pupils in count ies wit h a populat ion of 700,000 or more, as report ed by t he Depart ment of 7 Educat ion.
DCFS – Child Protective S ervices Description/ Purpose The Division of Child and Family S ervices provides direct child prot ect ive services t o t he 15 rural count ies in Nevada. Child prot ect ive services st aff respond t o report s of abuse or neglect of children under t he age of 18 and perform int ake funct ions, invest igat ions, and complet e case findings t o det ermine whet her t here is reasonable cause t o believe t hat a child is abused or neglect ed or t hreat ened wit h abuse or neglect . Authority/ Methodology NRS 432B.326 allows t he Division of Child and Family S ervices t o assess count ies whose populat ion is less t han 100,000 for child prot ect ive services. The assessment is calculat ed by t he t ime spent by st aff on child prot ect ive service act ivit ies, including salaries and proport ional operat ing expendit ures. Each count y is assessed based on t heir proport ionat e number of children ages 0-17 as est imat ed by t he S t at e Demographer. 8
DPBH – Environmental Health S ection Description/ Purpose Environment al Healt h S ect ion (EHS ) provides healt h inspect ions for count ies pursuant t o chapt ers 439 (Administ rat ion of Public Healt h), 444 (S anit at ion), 446 (Food Est ablishment s) and 583 (Meat , Fish, Poult ry and Eggs) of NRS . EHS focuses on prevent ion of disease t hrough sanit at ion, safe food and wat er, proper disposal of wast es, and promot ing safe and healt hy environment al condit ions t hroughout Nevada. Authority/ Methodology NRS 439.4905 allows the Division of Public and Behavioral Health to collect a fee from participating counties for services rendered. The Environmental Health S ection (EHS ) was approved for the Capped Assessment Amount of $592,426.00. This amount was originally calculated using a combination of Agency Personnel Costs, Operating Costs for County Programs, and In-S tate Travel Costs to provide public health services in participating counties. Each County contributes a proportionate amount of the assessment total to the Division every quarter of the financial year. The Environmental Health Program Manager conducts an annual inventory of consumer protection establishments which is used to re- calculate the amounts assessed based on the percentage of food establishments permitted in each county. That percentage is applied to the assessment total to calculate the annual amount to be assessed for each participating county. 9
DPBH – Community Health S ervices (CHS ) Description/ Purpose Communit y Healt h S ervices (CHS ) provides mandat ed public healt h services on behalf of 12 rural and front ier count ies in Nevada(Churchill, Elko, Esmeralda, Eureka, Humboldt , Lander, Lincoln, Lyon, Mineral, Nye, Pershing, and Whit e Pine). S ervices include conduct ing invest igat ions of infect ious diseases, including report s t o t he S t at e Chief Medical Officer; t est ing, cont rol, t reat ment and referral t o prevent spread of disease; vaccinat ion clinics relat ed t o serious out breaks of infect ious diseases; and part icipat ion in preparedness act ivit ies at a count y level, such as Point of Dispensing exercises. Authority/ Methodology NRS 439.4905 allows t he Division of Public and Behavioral Healt h t o collect a fee from part icipat ing count ies for services rendered. The count ies are charged and receive only t he mandat ory services list ed. The fee is calculat ed using a combinat ion of st at e personnel cost s, count y program and operat ing cost s, and a cont ribut ion t o t he Rural Elect ronic Healt h Record S yst em. 10
DPBH – CHS - TB Medical Care Description/ Purpose To assure counties are prepared to address a potential tuberculosis outbreak, CHS participates in local emergency preparedness committees, points of dispensing exercises, board of health meetings at a county level, and vaccine clinics separate from the routine child and adult wellness care vaccine clinics. Authority/ Methodology NRS 439.4905 allows the Division of Public and Behavioral Health to collect a fee from participating counties for services rendered. If there is an expansive tuberculosis outbreak, the affected counties pay for supplies outside of the established county assessment. 11
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